title: Ratings of patient-provider communication among veterans: serious mental illnesses, substance use disorders, and the moderating role of trust.
abstract: Many individuals with a mental illness are not satisfied with their communication with their primary provider. The present study examined the relationship of serious mental illness (SMI), substance use disorder (SUD), and trust for the provider with provider communication. The sample included Veterans Administration (VA) patients throughout the United States who either had a SMI diagnosis (schizophrenia or bipolar disorder) or were in a random sample of non-SMI patients (total N=8,089). Latent class (LC) modeling identified three classes of provider communication ratings in the sample: very good, good, and poor. In LC regression, poor trust for the provider was associated with a decrease in the likelihood of being in the "very good" or "good" compared to the "poor" provider communication ratings group, and the decrease was significantly greater for VA patients with a SMI or SUD diagnosis than those without. Training providers on creating trust is particularly important for those who serve patients with SMI and SUD diagnoses.
authors.affiliation: VA National Serious Mental Illness Treatment Resource and Evaluation Center and the Health Services, Research and Development Center of Excellence, Ann Arbor, Michigan 48109, USA. amybohne@med.umich.edu
authors.forename: Amy S B
authors.initials: AS
authors.lastname: Bohnert
authors.forename: Kara
authors.initials: K
authors.lastname: Zivin
authors.forename: Deborah E
authors.initials: DE
authors.lastname: Welsh
authors.forename: Amy M
authors.initials: AM
authors.lastname: Kilbourne
mesh_terms: D000368:Aged; D003142:Communication; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders; D008875:Middle Aged; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D012720:Severity of Illness Index; D019966:Substance-Related Disorders; D035502:Trust; D014481:United States; D014728:Veterans